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At least 433 records · Page 24Linked to original sources
PubMed2005

Postacute care services use for dysvascular amputees: a population-based study of Massachusetts.

OBJECTIVE: Rehabilitation and other postacute care services utilization for persons with a lower limb amputations due to dysvascular disease is important information for physiatrists, therapists, patients, and health-policy planners. The purpose of this study was to examine rates of inpatient rehabilitation services use in a statewide population. DESIGN: Massachusetts Hospital Case Mix and Charge Data for 1997 were used to select persons with dysvascular limb amputations. Disposition locations after amputation were analyzed. RESULTS: There were 2487 persons who incurred a lower limb amputation, with the majority being white (94%), male (58%), and elderly (69 yrs). Most had diabetes (62%) or peripheral vascular disease (51%). The most common disposition was home (33%), with 16% receiving inpatient rehabilitation after amputation. Persons with transtibial and transfemoral amputations were the most likely to receive inpatient rehabilitation, 28% and 19% respectively. CONCLUSIONS: Sixteen percent of dysvascular amputees received inpatient rehabilitation services. This was higher than the 1997 rate for Maryland (12%) and suggests geographic differences in services utilization. Prospective studies are necessary to examine outcomes for persons receiving rehabilitation services in different care settings to define the optimal rehabilitation venue for functional restoration. Development of more specific International Classification of Diseases, Ninth Revision-Clinical Modification codes for dysvascular amputations would further research and public policy efforts.

Aged↗
PubMed1992

Risk factors for disease in a homeless population.

Risk factors of smoking, drug and alcohol abuse, obesity, and sedentary lifestyle were related to health problems of clients at a walk-in clinic for the homeless. The sample of 1252 clients was predominately male (91.4%) and multiethnic, with a majority (65%) age 18 to 40 years. Data on diagnoses of health-related conditions were collected from clinic charts, coded into ICD categories, analyzed for relationships of risk factors to health problems, and compared with categories of diagnoses in a matched national sample of ambulatory care visits. Findings indicate that a larger proportion of homeless suffered from health problems in 24 of 27 diagnostic categories than the nonhomeless. Most prevalent were respiratory, dermal conditions, injuries, and digestive problems, in that order. Risk factors of alcohol abuse, smoking, sedentary lifestyle, drug abuse, and obesity were predictive of health problems in 18 of the categories analyzed. The findings suggest that immediate interventions such as education and rehabilitation to reduce risk factors, and provision of facilities for personal hygiene and cleaning of clothing could reduce some of the health-related conditions in this population while longer-term solutions of housing and employment are sought. The analysis model developed here appears to be a useful way of comparing relative effects of risk factors as a basis for establishing priorities for interventions.

Adolescent↗
PubMedDate not supplied

Anemia and cost in Medicare patients with congestive heart failure.

The objective of this study was to examine the total cost to Medicare associated with the presence of anemia in congestive heart failure (CHF) patients. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify anemia, CHF, and comorbid conditions in 2002, and total Medicare costs were calculated for 2003. The mean patient age was 77.8 years. Anemia, present in 32% of CHF patients, was associated with older age, female sex, non-white race, and increasing burden of comorbidity. The total per-member-per-month cost in 2003 was $1781.01 among CHF patients with anemia in the preceding year compared with $1142.38 for CHF patients without anemia, a ratio of 1.56 (95% confidence interval, 1.5589-1.5592). When adjustment was made for baseline demographic factors and comorbid conditions, the corresponding ratio was 1.25 (95% confidence interval, 1.2546-1.2548). Anemia, a common association of CHF in elderly patients, is an antecedent association of increased societal medical expenditure.

Aged↗
PubMed2006

Prevalence of immune thrombocytopenia: analyses of administrative data.

BACKGROUND: The prevalence of immune thrombocytopenic purpura (ITP) in the USA is unknown. The paucity of data makes clinical trial design and resource allocation challenging. OBJECTIVES: We aimed to quantify the prevalence of ITP in one state and to report on utilization of resources. METHODS: The Maryland Health Care Commission supplied utilization data on all privately insured Maryland residents in 2002. We identified patients having two claims, separated by at least 30 days, for International Classification of Diseases, Ninth Revision, Clinical Modification code 287.3 (expected to be predominantly ITP). We excluded patients with concurrent diagnoses that made ITP unlikely. In sensitivity analyses, we varied the required visit interval between 14 and 180 days. We quantified ITP prevalence, resource utilization, and prevalence of concurrent autoimmune illnesses. RESULTS: The age-adjusted prevalence of ITP was 9.5 per 100,000 persons (10.5 per 100,000 when requiring a minimum 14-day interval and 4.5 per 100,000 with a 180-day interval). There was a predominance of males in childhood and of females in the middle-adult years, with an overall prevalence rate ratio of 1.9 for females to males. Twenty per cent of these patients were hospitalized, but emergency department use was rare, as was splenectomy. A concurrent diagnosis of multiple sclerosis was 25 times more prevalent than anticipated. CONCLUSIONS: We conclude that the prevalence of ITP in one populous state in the USA is comparable with that which has been reported in Europe. The suggested co-occurrence of ITP and multiple sclerosis in children merits further investigation.

Adolescent↗
PubMed2001

The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study.

OBJECTIVE: The aim of this study was to determine the prevalence of the major extraintestinal manifestations of inflammatory bowel disease (IBD) and their relation to disease diagnosis and gender. METHODS: We used the population-based University of Manitoba IBD Database, which includes longitudinal files on all subjects of all health system contacts identified by International Classification of Diseases, 9th Revision, Clinical Modification codes for visit diagnosis. We extracted a cohort from our database, which included subjects with a known diagnosis of IBD for at least 10 yr. We then determined how many contacts each subject had for each of the following extraintestinal IBD-associated immune diseases: primary sclerosing cholangitis, ankylosing spondylitis, iritis/uveitis, pyoderma gangrenosum, and erythema nodosum. We calculated the prevalence of the extraintestinal diseases using an administrative definition of having at least five health system contacts for the diagnosis in question. This administrative definition has previously been validated in Crohn's disease and ulcerative colitis (UC). RESULTS: A total of 6.2% of patients with IBD had one of six major extraintestinal diseases studied in this report. Only 0.3% of patients had multiple extraintestinal diseases. Iritis/uveitis was the most common extraintestinal disease of all assessed (2.2% of women and 1.1% of men). Iritis/uveitis was more common among women, particularly those with UC (3.8%). Primary sclerosing cholangitis was most common among men with UC (3%). Ankylosing spondylitis was more common among men, and the highest rate was seen among men with Crohn's disease (2.7%). Pyoderma gangrenosum was more common in Crohn's (1.2%) with no gender predilection. Erythema nodosum was similarly present in Crohn's and UC but was more common among women (1.9%). CONCLUSIONS: The associations of immune mediated diseases in extraintestinal sites may help us to further our understanding of IBD pathogenesis, and it may help us in developing a paradigm of disease subsets.

Adult↗
PubMed1983

Ethical aspects of clinical chemistry.

The work performed by the clinical chemist may deeply affect the decisions of the doctor and the well-being of the patient. Yet in contrast to the doctor and to the nurse the clinical chemist usually has no personal relationship with the patient. Being encumbered by much technology and anonymity is itself a reason for scrutinising his involvement in issues of health care ethics. This is an attempt at clarifying some major aspects: the relationship of his professional ethics to medical ethics as a whole, his ethical obligations to the patient and to society, and other aspects.

Chemistry, Clinical↗
PubMed2005

Determinants of hospital length of stay among patients with pneumonia admitted to a large Canadian hospital from 1991 to 2001.

BACKGROUND: Pneumonia is a common reason for hospital admission, and the cost of treatment is primarily determined by length of stay (LOS). OBJECTIVES: To explore the changes to and determinants of hospital LOS for patients admitted for the treatment of community-acquired pneumonia over a decade of acute hospital downsizing. METHODS: Data were extracted from the database of Vancouver General Hospital, Vancouver, British Columbia, on patients admitted with community-acquired pneumonia (International Classification of Diseases, Ninth Revision, Clinical Modification codes 481.xx, 482.xx, 483.xx, 485.xx and 486.xx) from January 1, 1991 to March 31, 2001. The effects of sociodemographic factors, the specialty of the admitting physician (family practice versus specialist), admission from and/or discharge to a long-term care facility (nursing home) and year of admission, adjusted for comorbidity, illness severity measures and other potential confounders were examined. Longitudinal changes in these factors over the 10-year period were also investigated. RESULTS: The study population (n=2495) had a median age of 73 years, 53% were male and the median LOS was six days. Adjusted LOS was longer for women (10% increase, 95% CI 3 to 16), increasing age group (7% increase, 95% CI 4 to 10), admission under a family physician versus specialist (42% increase, 95% CI 32 to 52) and admission from home with subsequent discharge to a long-term care facility (75% increase, 95% CI 47 to 108). Adjusted hospital LOS decreased by an estimated 2% (95% CI 1 to 3) per annum. The mean age at admission and the proportion admitted from long-term care facilities both increased significantly over the decade (P<0.05). CONCLUSIONS: Results suggest that the management of hospitalized patients with pneumonia changed substantially between 1991 and 2001. The interface of long-term care facilities with acute care would be an important future area to explore potential efficiencies in caring for patients with pneumonia.

Adolescent↗
PubMed2005

Hospital volume and selection of valve type in older patients undergoing aortic valve replacement surgery in the United States.

BACKGROUND: Hospital volume has been linked to quality of care. The relation between hospital volume and recommended use of bioprosthetic valves in older patients undergoing aortic valve replacement (AVR) is unknown. METHODS AND RESULTS: We identified 80,470 patients aged > or =65 years undergoing isolated AVR (with or without bypass surgery) in 1045 US hospitals during 1999-2001 from Medicare Part A files. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify patients undergoing bioprosthetic valve (35.21) or mechanical valve (35.22) AVR. The sample was categorized into deciles on the basis of the valve surgery volume of the hospital. Generalized estimating equations determined the relative risk of receiving a bioprosthetic valve in different volume deciles, with adjustment for age, gender, race, comorbidity, and other factors. Bioprosthetic valve use increased (P<0.001) from 44% in 1999 to 52% in 2001 and with age (from 36% in patients aged 65 to 69 years to 60% in patients aged > or =90 years). Rates were directly related (P<0.001) to volume, rising from 28% in the 1st decile to 68% in the 10th decile. With the use of generalized estimating equations, the relative risk of bioprosthetic valve use, relative to the 1st decile, progressively increased from 1.2 (95% CI, 1.1 to 1.4) in the 2nd decile to 2.3 (95% CI, 1.9 to 2.7) in the 10th decile. CONCLUSIONS: Hospital volume was a strong predictor of bioprosthetic valve use in older patients undergoing AVR. The lower use of bioprosthetic valves in low-volume hospitals is at odds with recent guidelines recommending bioprosthetic valves in patients aged > or =65 years. These findings further support the use of volume as a marker of hospital quality.

Age Factors↗
PubMed2000

Socioeconomic status is an important determinant of the use of invasive procedures after acute myocardial infarction in New York State.

BACKGROUND: Patient and hospital characteristics influence the use of invasive cardiac procedures. Whether socioeconomic status (SES) has an influence that is independent of these other determinants is unclear. The purpose of the present study was to examine the influence of household income as a measure of SES on the use of invasive cardiac procedures among a large group of patients with acute myocardial infarction. METHODS AND RESULTS: We analyzed administrative discharge data from 231 nonfederal acute care hospitals in New York State that involved 28 698 black or white inpatients with International Classification of Diseases, Ninth Revision, Clinical Modification code 410.XX in the principal diagnosis position between January 1 and December 31, 1995. Household income was derived from postal ZIP codes and census data. The use of cardiac catheterization, PTCA, CABG, and any revascularization procedure was examined across groups stratified by income. Patients who resided in lower-income neighborhoods were more often female or black, had a higher prevalence of coexistent illness, had a higher use of Medicaid insurance, and were less often admitted to urban hospitals or hospitals that provide on-site CABG and PTCA. Crude and adjusted odds ratios for catheterization, PTCA, CABG, and any revascularization procedure were related to income in a graded fashion. After adjustment, patients in the highest quintile of income were 22% more likely to undergo catheterization, 74% more likely to undergo PTCA, 48% more likely to undergo CABG, and 76% more likely to undergo any revascularization procedure than were patients in the lowest quintile. The difference in cardiac catheterization did not fully account for income-based differences in revascularization, because income remained a significant determinant of revascularization after accounting for whether a catheterization was performed. Even among patients treated in hospitals that provide on-site CABG and PTCA, income was a significant determinant of procedures. CONCLUSIONS: Lower-income patients hospitalized for acute myocardial infarction are more often female or black, have more coexisting illnesses, and are less often admitted to urban hospitals or hospitals that provide CABG and PTCA. Even after adjustment for these and other factors, lower income is a negative predictor of procedure use.

Black or African American↗
PubMed2003

Long-term mortality in cerebrovascular disease.

BACKGROUND AND PURPOSE: Stroke is the third leading cause of death in the United States, yet data are limited about the temporal pattern of mortality among patients with cerebrovascular disease. The objectives of this study were to identify predictors of 6-month mortality and to evaluate 5-year mortality in patients with cerebrovascular disease. METHODS: Our population included fee-for-service Medicare beneficiaries aged > or =65 years who were discharged with an acute ischemic stroke, transient ischemic attack (TIA), or carotid stenosis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 433 to 436) from Connecticut acute care hospitals in 1995. This cohort was followed through 2000 by means of part A Medicare claims and Social Security Administration mortality data. RESULTS: Among 5123 patients, 4781 survived their hospitalization and were followed for an average of 3.4 years; 670 (14.0%) died within 6 months of discharge, and 2517 (52.6%) died within 5 years. Predictors of 6-month mortality included older age, male sex, increasing comorbidity, discharge not to home, and prior admission within a year of the index hospitalization. The annual mortality rates for year 1 after discharge differed depending on the discharge diagnosis of the index hospitalization: carotid stenosis, 10.6%; TIA, 14.8%; and acute ischemic stroke, 26.4%. The 5-year cumulative mortality rates were as follows: carotid stenosis, 38.3%; TIA, 49.6%; and acute ischemic stroke, 60.0%. CONCLUSIONS: Mortality after acute ischemic stroke, TIA, and carotid stenosis is substantial. Rates and patterns of mortality differ according to patients' discharge diagnoses.

Acute Disease↗
PubMed2004

Charlson Index comorbidity adjustment for ischemic stroke outcome studies.

BACKGROUND AND PURPOSE: The Charlson Index is commonly used in outcome studies to adjust for patient comorbid conditions, but has not been specifically validated for use in studies of ischemic stroke. The purpose of the present study was to determine whether outcomes of ischemic stroke patients varied on the basis of the Charlson Index. METHODS: The Department of Veterans Affairs (VA) Stroke Study prospectively identified stroke patients admitted to 9 VA hospitals between April 1995 and March 1997. The Charlson Index was scored on the basis of discharge International Classification of Diseases, 9th Revision, Clinical Modification coding and dichotomized (low comorbidity 0 or 1 versus high > or =2) for analysis. Validity was assessed on the basis of modified Rankin score at hospital discharge (good outcome 0 or 1 versus poor > or =2 or dead) and 1-year mortality, adjusting for initial stroke severity. RESULTS: Of the 960 enrolled ischemic stroke patients, 23% had a Charlson Index of 0, 34% 1, 22% 2, 12% 3, and 8% > or =4. Forty-eight percent of those with a low Charlson Index had a good outcome at discharge versus 37% of those with a high Charlson Index (P<0.001). For 1-year mortality, the proportions were 16% versus 26%, respectively (P<0.001). Logistic regression adjusting for initial stroke severity showed that those with a high Charlson Index had 36% increased odds of having a poor outcome at discharge (P=0.038) and 72% greater odds of death at 1 year (P=0.001). Every 1-point increase in Charlson Index was independently associated with a 15% increase in the odds of a poor outcome at discharge (P<0.005) and a 29% increase in the odds of death by 1 year (P<0.001). CONCLUSIONS: These data support the validity of the Charlson Index as a measure of comorbidity for use in ischemic stroke outcome studies.

Aged↗
PubMed2005

Improved quality of stroke care for hospitalized Medicare beneficiaries in Michigan.

BACKGROUND AND PURPOSE: We reported previously that acute ischemic stroke patients encountered delays in obtaining neuroimaging and receiving thrombolysis, and that deep venous thrombosis prophylaxis was used only in a minority of eligible patients. We investigated whether these and other measures improved after a quality improvement initiative. METHODS: Medicare fee-for-service ischemic stroke and transient ischemic attack discharges in 136 acute care hospitals in Michigan were identified by International Classification of Diseases, 9th Revision, Clinical Modification codes. Only patients with stroke symptoms persisting for >1 hour and present on arrival were included in the analysis. Seven quality indicators were abstracted from chart review at baseline (discharges between July 1, 1998, and June 30, 1999) and at remeasurement (discharges between January 1, 2001, and June 30, 2001) after an intensive quality improvement initiative throughout Michigan hospitals. Quality indicators were compared at baseline and remeasurement. RESULTS: Indicators of care were determined in 5146 patients at baseline and 4980 patients on remeasurement. Four quality-of-care indicators showed significant improvement on remeasurement: antithrombotic prescribed at discharge (81.9 baseline versus 83.7% remeasurement; P=0.026), avoidance of sublingual nifedipine in patients with acute ischemic stroke (97.1 versus 99.7%; P<0.0001), documentation of a computed tomography (CT)/MRI during hospitalization (98.0 versus 99.1%; P=0.024), and appropriate deep venous thrombosis prophylaxis (13.8 versus 26.9%; P<0.0001). Time to CT/MRI did not significantly change, but time to thrombolysis improved (113 versus 88.5 minutes; P=0.045). CONCLUSIONS: Improvement occurred in several indicators of quality of care in Michigan Medicare beneficiaries presenting with acute stroke symptoms.

Administration, Sublingual↗
PubMed2006

Use and effectiveness of warfarin in Medicare beneficiaries with atrial fibrillation.

BACKGROUND AND PURPOSE: More than 2 million Americans have atrial fibrillation, and without antithrombotic therapy, their stroke rate is increased 5-fold. In randomized controlled trials, warfarin prevented 65% of ischemic strokes (hazard ratio [HR], 0.35; 95% CI, 0.26 to 0.48) compared with no antithrombotic therapy. However, the effectiveness of warfarin therapy outside of clinical trials is unknown, especially in black and Hispanic populations. Our goal was to quantify use of warfarin therapy, frequency of International Normalized Ratio monitoring, and effectiveness for stroke prophylaxis in Medicare beneficiaries with atrial fibrillation. METHODS: This was a cohort study of Medicare beneficiaries with atrial fibrillation who were hospitalized between March 1998 and April 1999 in all 50 US states. The primary outcome was incident hospitalizations for ischemic stroke based on validated International Classification of Diseases, 9th Revision, Clinical Modification codes. RESULTS: Two thirds of ideal anticoagulation candidates were prescribed warfarin on hospital discharge. In unadjusted analyses, the stroke rates per 100 patient years of warfarin therapy were 5.2 in (non-Hispanic) white Medicare beneficiaries, 10.6 in black beneficiaries, and 12.2 in Hispanic beneficiaries. After adjusting for comorbid conditions, warfarin prescription was more frequent and monitoring more regular in white Medicare beneficiaries than in black or Hispanic beneficiaries (P<0.0001). Warfarin use was associated with 35% fewer ischemic strokes (HR, 0.65; 95% CI, 0.55 to 0.76) compared with no antithrombotic therapy but was less effective in black and Hispanic beneficiaries (P for interaction=0.048). CONCLUSIONS: The use, monitoring, and effectiveness of warfarin therapy are suboptimal in Medicare beneficiaries, especially in black and Hispanic beneficiaries.

Aged↗
PubMed1994

Use of Medicare claims data to estimate national trends in stroke incidence, 1985-1991.

BACKGROUND AND PURPOSE: Although stroke mortality has been declining in the United States for decades, recent trends in stroke incidence based on national data have not been described. We used Medicare hospitalization data to estimate national trends in the incidence of stroke among Americans aged 70 years or older, and we provide evidence of the validity of the estimate. METHODS: We defined stroke as a principal diagnosis with International Classification of Diseases, 9th Revision, Clinical Modification codes 430 to 434 or 436 to 437. We excluded many recurrent cases from the analysis by eliminating persons hospitalized for stroke during the 5 years preceding the index stroke. We calculated annual adjusted incidence rates and examined trends graphically. We investigated the effect of different exclusion periods, trends in in-hospital mortality of stroke patients, and trends in out-of-hospital stroke mortality. We examined trends in relation to sex, race, and age. RESULTS: The estimated age- and sex-adjusted stroke incidence declined 9.5% from 1985 to 1989, then increased 3.3% to 1991. The pattern did not vary with the length of the exclusion period or when all listed diagnosis rather than principal diagnoses were used to identify stroke cases. Incidence trends resembled the overall trend for both men and women, for 5-year age groups, and for whites; the trend did not change for blacks. CONCLUSIONS: Stroke incidence declined steadily from 1985 to 1989 and then increased slightly to 1991. Several postulated potential sources of bias were investigated and found to be unlikely to account for the incidence decline, although some may have contributed to the subsequent incidence increase.

Age Factors↗
PubMed2002

Occurrence of secondary ischemic events among persons with atherosclerotic vascular disease.

BACKGROUND AND PURPOSE: Few data exist for large managed care populations on the occurrence of subsequent acute ischemic events in persons with established atherosclerotic vascular disease. We estimated the occurrence of secondary stroke, acute myocardial infarction (AMI), and vascular deaths among 2 large, managed care samples. METHODS: With the use of International Classification of Diseases, Ninth Revision, Clinical Modification codes, patients aged > or =40 years and with stroke, AMI, or peripheral arterial disease (PAD) were identified from administrative data of UnitedHealthcare plans during 1995-1998. Stroke, AMI, and PAD cohorts were identified within a commercial insurance sample and a Medicare sample. Cumulative occurrences of subsequent stroke, AMI, or vascular death were estimated by survival analysis. RESULTS: In the stroke commercial cohort (n=1631; mean age, 62.1 years), cumulative occurrence of subsequent events was 4.2%, 6.5%, 9.8%, and 11.8% at 0.5, 1, 2, and 3 years, respectively; cumulative secondary event occurrence in the AMI commercial cohort (n=6458; mean age, 56.0 years) was 3.5%, 4.8%, 7.3%, and 8.5% and in the PAD commercial cohort (n=5813; mean age, 59.2 years) was 1.5%, 2.8%, 4.8%, and 6.5%, respectively. Cumulative secondary event occurrences were even higher in stroke (n=1518; mean age, 79.5 years), AMI (n=2197; mean age, 76.2 years), and PAD (n=5033; mean age, 76.6 years) cohorts of the Medicare sample: 18.1%, 17.0%, and 8.7%, respectively, at 3 years. More than 75% of each stroke cohort's secondary events were strokes; more than 75% of each AMI cohort's secondary events were AMIs. Of the PAD cohorts' secondary events, 27% to 39% were strokes, 48% to 57% were AMIs, and 13% to 16% were vascular deaths. CONCLUSIONS: Among these managed care enrollees with existing atherosclerotic vascular disease, subsequent ischemic events represent a significant symptomatic disease burden. Given these findings, it is very important to determine whether secondary prevention strategies are being effectively used to manage patients with diagnosed atherosclerosis.

Adult↗
PubMed1993

The MMPI and MMPI-2 in an outpatient sample: comparisons of code types, validity scales, and clinical scales.

Two hundred (N = 200) outpatients completed MMPI (W.G. Dahlstrom, Walsh, & L.G. Dahlstrom, 1989) and MMPI-2 (Butcher, W.G. Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) items at one time, permitting comparison of alternate forms. The concordance rate for elevated codetypes was 58%; for 2-point codetypes independent of elevation, it was also 58%. Only 50% of the men compared to 66% of the women showed concordance between forms. Of the 200 cases, 72 (36%) had codetypes that were both elevated and "well defined." The concordance rate among these 71 cases was 72%. Comparison of mean raw scores for the validity and clinical scales showed a small difference for MMPI versus MMPI-2 (Form) on Scales 2 and 5, small differences for Gender on Scales 1, 2, and 3, and no Gender by Form interactions. There were significant MMPI versus MMPI-2 differences for T-scores on all scales, and there were significant Gender by Form interactions for T-scores on all scales except Scale L, Scale K, and Scale 6 (excluding Scale 5). Comparison of mean T-scores (excluding Scale 5) showed no significant differences for Gender on the 12 scales. In spite of significant mean differences, correlational analyses show correlations above .96 for the raw scores and T-scores for each gender, indicating that rank ordering of cases is maintained between forms. These results are discussed in terms of the issues for use of the MMPI-2 compared to the MMPI.

Adult↗